What We Treat
Common Conditions
Click on the ZONES for more infomation on the foot conditions we regularly treat
Top of the foot (Dorsal)
Conditions:
Involution
Involution is a condition where the nail has an abnormal increased curvature
causing the nail plate to peak. The curvature can be so excessive in some patient
that the borders of the nail may even appear to curl in on themselves. Some patient
has involution of the nail without any problems at all, while others find it some
painful that nail surgery is sometimes advised.
Ingrown Toenail (Onychocryptosis)
Almost everyone has at least heard of the dreaded ingrown toenail. This painful
condition develops when a spike or a serrated edge of nail has pierced the skin
adjacent to it. This can subsequently become infected and may have
hypergranulation tissue growth if left too long with out treatment. Podiatrists will
endeavour to manage conservatively when possible however, often when we see
them there is not other option except surgery.
Subungal Exostosis
Subungal exostosis occurs when a small outgrowth of bine forms under the nail
plate from the tiny bones within the toe. They can be slow growing to start with but
can lead to daily pain for some sufferers. The cause of subungal exostosis is thought
to be trauma, possibly dropping something on or stubbing the toe. As they grow
they can cause a worrying growth to develop under the nail plate and may produce
exudate.
Thickened Toenails (Onychauxis)
Onychauxis is the name given to the common nail abnormality causing uniform
thickening of the nail plate. Sometime these thick nails can become discoloured
causing some sufferers to become self conscious about their feet. Most of the time its
the big toe nail thats affected but it can occur in any toe. Its important in the elderly
to maintain theses conditions to prevent more serious problems such as subungal
aseptic necrosis developing.
Ram’s Horn Nail (Onychogryphosis)
Onychogryphosis is almost unmistakable because of it obvious resemblance to a
rams horn. These nails are often dark yellow or brown colour. Most of the time its
the big toenail thats affected. It cause is thought to come from the uneven
production of the nail plate cells at the matrix, where the nail is produced. It can be
incredibly uncomfortable and unfortunately is seen most often in the elderly or in
cases of neglect.
Corn Under The Nail (Subungal Heloma)
A subungal heloma is just like any other hard corn but unfortunately its located
under the nail plate. Hard cords are caused by prolonged pressure and the result is
the skins reaction to that enduring force causing keratin to be produced quickly, in
order to protect, however, more often that not if becomes incredibly painful for the
sufferer. In order to remove the corn the nail will need to be cut back to allow access
for the podiatrist. If the pressure which caused the corn remains the suffer can
expect it to return. That's why addressing any footwear issues is critical for a long
term, satisfactory outcome.
Paronychia
This is the name given to the inflammation and/or infection of the tissue
surrounding the nail plate. Although paronychia may not sound too serious they can
result in tracking bacterial infection so should never be ignored. Patients often
require antibiotic treatment, draining and dressings of the infected site.
Fungal Nail Infections (Onychomychosis and Tinea Unguium)
Fungal nails account for one of the most common conditions we see relating to the
nail. Sufferers from fungal nail infection can become very self conscious about their
feet. The human nail plate provides a very stable environment for the fungus to
grow. Infected nails may become thick, brittle, powdery or yellow brown
appearance.
Having associated skin infections is thought to contribute to the development of
fungal nail infections which is is why its important when treating fungal nail problems that the treatment of the skin is part of the process.
Treatment of fungal skin and nail infections can take a frustratingly long time to
resolve. Working closely with your podiatrist will provide the best outcomes. Be
prepared for regular check ins with your podiatrist for frequent nail debulking and/
or treatment application.
Click Here To Download our MANAGING NAIL CONDITIONS eBOOK
Conditions:
Hammer toe
Hammertoe is the term used to describe a deformity of one or more of the lesser toes
where one or both joints of the toes caused by an imbalance in the muscle control to
the toes. For some people this deformity can result in abnormal pressure from
footwear which can result in callus, corns and other painful skin changes.
Click Here To Download our MANAGING DIGITAL CONDITIONS eBOOK
Conditions:
Hallux valgus
Otherwise known as a 'bunion', hallux valgus causes an inward deformity of the big to resulting in a subluxation of the joint causing arthritic pain and friction from footwear.
Hallux limitus/rigidus
Hallux limitus/rigidus is loss of full motion in the joint of the big toe caused by biomechanical dysfunction that can also lead to arthritic changes in the joint.
Turf toe
Turf toe is caused by trauma where the big toe hits the ground during sport causing the joint to compress. It can cause long term joint damage if not managed correctly.
Inter-metatarsal Bursitis
Bursae are fluid filled structures which surround our joints, tendons, ligaments and
within various layers / structures within our bodies. Bursae are essential to reduce
friction, and help structures to glide easily, providing protection for the anatomy.
The inter-metatarsal bursae are located on the bottom of the foot near the base of
the toes. They can become inflamed when the forces acting on the are excessive
caused by loss of fatty protection, walking barefoot, or excessive loading through
over training of wearing the wrong shoe.
Capsulitis
Our joints are lined with protective covering Inflammation of the tissues that line the
joints, often under the ball of the foot. It causes redness, swelling, warmth, and pain
on weight bearing or with joint motion. Sometimes if they are inflamed weight
bearing can be painful, and you may have redness, heat and/or swelling.
Plantar Plate Tear / Rupture
Plantar plate injuries have become better understood recently owing to the
improvements in medial imaging. The plate is a thick ligament under the ball of the
foot which extends to the first joints of the toes. It protects toe joints from pressure
and injury and prevents excessive dorsiflexion. When the plantar plate is injured,
you may feel anything form moderate to severe symptoms. You might even notice
that one or more of your toes has ‘Popped” up or become splayed. Sufferers often
describe a feeling of walking on a stone in plantar plate injury.
Stress / March Fracture
Stress Fractures are quite a common cause of foot pin, especially in runners or
athletes who have increased their training loads or regimes causing repeated
trauma to a small area of bone. Calcium and vitamin D deficiency is linked with
stress fracture along with osteoporosis.
Freibergs Disease
Freibergs disease is not common but its something to be aware of, particularly in
adolescents who are still growing. Its causes by necrosis ( death ) of the bone of the
metatarsal head ( osteonecrosis). It’s also sometimes called Freiberg’s infarction.
Nerve Entrapment / Neuroma
Neuromas can occur anywhere. In the forefoot they’re most commonly encountered
between the lesser metatarsals, typically 3rd and 4th. They’re caused by an
inflammation and thickening of the perineurial sheath which covers the nerve. When
the become bigger (space occupying) they can become very sore. Neuromas are
relatively common. They can be aggravated by tight fitting shoes and can cause
pain which radiates up or around the foot. Typically the pain doesn’t make much
sense for the sufferer and they often find it hard to describe.
Click Here To Download our MANAGING FOREFOOT CONDITIONS eBOOK
Conditions:
LISFRANCS INJURY
The Lisfranc joint is the area of articulation between the mid foot and forefoot: Its
made up of the five tarsometatarsal joints in all. Foot fractures and traumatic
ligament injuries can result in deformity, instability, pain and degenerative disease
of the Lisfranc joint. Injuries to the Lisfranc ligament complex have been associated
with high-energy trauma (eg, motor vehicle collisions), they can also result from
low-energy trauma, including leisure activities or athletic activity.You may notice a
defined area of bruising to the sole of the foot. This is often a sign of Lisfrancs injury.
MID FOOT ARTHRITIS
The foot anatomy is complex. The foot itself has 26 bones on average with a
multitude of small articular surfaces among its 33 joints. Many of these joints are
small but the forces we place through them are huge. Over the course of our normal
daily activities, these joints can change, become damaged and dysfunctional. This is
the arthritic process and the small joints in the feet are particularly vulnerable,
causing achy stiffness or pain during or after exercise.
PLANTAR FIBROMA
The most common cause of lumps to the sole of the foot, fibromas are benign fibrous
lumps which can be annoying at best and painful at worst. They can occur on their
own of be part of a multifocal lesion. Treatment includes simple off loading,
imaging, injection of steroid and surgical excision.
PERONEAL / OVERUSE INJURY
The peroneals are the stabilising muscles and tendons located at the outer aspect of
the lower leg. One of these (peroneus brevis) has its tendon enter the foot to the
outer aspect and attach to the base of the 5th metatarsal. The insertion on peroneus brevis is exposed to injury and over use resulting tendonitis, rupture, or subluxation
(displacement) of the tendon.
JONES FRACTURE
This is the name given to the transverse fracture to the base of the 5th metatarsal.
Running sports or sports with aggressive lateral manoeuvres can lead to jones
fractures. They’re also common in athletes taking part in studded field sports the
foot is rapidly forced to an inverted / adducted position.
CUBOID DYSFUNCTION
Cubiod dysfunction can be especially annoying for sufferers and often goes
undiagnosed following a lateral ankle sprain or something as simple as a stumble
from a step for example. Having a displace cuboid bone will affect the overall foot
function and can result in an achy pain to the sole of the foot which in some cases,
radiate through to the top of the foot. It can be relentless for people who have it.
Podiatric foot manipulation techniques can relocate the cuboid bone with affects
often noticeable immediately.
Click Here To Download our MANAGING MIDFOOT CONDITIONS eBOOK
Conditions:
Hammer toe
Hammertoe is the term used to describe a deformity of one or more of the lesser toes
where one or both joints of the toes caused by an imbalance in the muscle control to
the toes. For some people this deformity can result in abnormal pressure from
footwear which can result in callus, corns and other painful skin changes.
Click Here To Download our MANAGING DIGITAL CONDITIONS eBOOK
Conditions:
Hallux valgus
Otherwise known as a 'bunion', hallux valgus causes an inward deformity of the big to resulting in a subluxation of the joint causing arthritic pain and friction from footwear.
Hallux limitus/rigidus
Hallux limitus/rigidus is loss of full motion in the joint of the big toe caused by biomechanical dysfunction that can also lead to arthritic changes in the joint.
Turf toe
Turf toe is caused by trauma where the big toe hits the ground during sport causing the joint to compress. It can cause long term joint damage if not managed correctly.
Inter-metatarsal Bursitis
Bursae are fluid filled structures which surround our joints, tendons, ligaments and
within various layers / structures within our bodies. Bursae are essential to reduce
friction, and help structures to glide easily, providing protection for the anatomy.
The inter-metatarsal bursae are located on the bottom of the foot near the base of
the toes. They can become inflamed when the forces acting on the are excessive
caused by loss of fatty protection, walking barefoot, or excessive loading through
over training of wearing the wrong shoe.
Capsulitis
Our joints are lined with protective covering Inflammation of the tissues that line the
joints, often under the ball of the foot. It causes redness, swelling, warmth, and pain
on weight bearing or with joint motion. Sometimes if they are inflamed weight
bearing can be painful, and you may have redness, heat and/or swelling.
Plantar Plate Tear / Rupture
Plantar plate injuries have become better understood recently owing to the
improvements in medial imaging. The plate is a thick ligament under the ball of the
foot which extends to the first joints of the toes. It protects toe joints from pressure
and injury and prevents excessive dorsiflexion. When the plantar plate is injured,
you may feel anything form moderate to severe symptoms. You might even notice
that one or more of your toes has ‘Popped” up or become splayed. Sufferers often
describe a feeling of walking on a stone in plantar plate injury.
Stress / March Fracture
Stress Fractures are quite a common cause of foot pin, especially in runners or
athletes who have increased their training loads or regimes causing repeated
trauma to a small area of bone. Calcium and vitamin D deficiency is linked with
stress fracture along with osteoporosis.
Freibergs Disease
Freibergs disease is not common but its something to be aware of, particularly in
adolescents who are still growing. Its causes by necrosis ( death ) of the bone of the
metatarsal head ( osteonecrosis). It’s also sometimes called Freiberg’s infarction.
Nerve Entrapment / Neuroma
Neuromas can occur anywhere. In the forefoot they’re most commonly encountered
between the lesser metatarsals, typically 3rd and 4th. They’re caused by an
inflammation and thickening of the perineurial sheath which covers the nerve. When
the become bigger (space occupying) they can become very sore. Neuromas are
relatively common. They can be aggravated by tight fitting shoes and can cause
pain which radiates up or around the foot. Typically the pain doesn’t make much
sense for the sufferer and they often find it hard to describe.
Click Here To Download our MANAGING FOREFOOT CONDITIONS eBOOK
Conditions:
LISFRANCS INJURY
The Lisfranc joint is the area of articulation between the mid foot and forefoot: Its
made up of the five tarsometatarsal joints in all. Foot fractures and traumatic
ligament injuries can result in deformity, instability, pain and degenerative disease
of the Lisfranc joint. Injuries to the Lisfranc ligament complex have been associated
with high-energy trauma (eg, motor vehicle collisions), they can also result from
low-energy trauma, including leisure activities or athletic activity.You may notice a
defined area of bruising to the sole of the foot. This is often a sign of Lisfrancs injury.
MID FOOT ARTHRITIS
The foot anatomy is complex. The foot itself has 26 bones on average with a
multitude of small articular surfaces among its 33 joints. Many of these joints are
small but the forces we place through them are huge. Over the course of our normal
daily activities, these joints can change, become damaged and dysfunctional. This is
the arthritic process and the small joints in the feet are particularly vulnerable,
causing achy stiffness or pain during or after exercise.
PLANTAR FIBROMA
The most common cause of lumps to the sole of the foot, fibromas are benign fibrous
lumps which can be annoying at best and painful at worst. They can occur on their
own of be part of a multifocal lesion. Treatment includes simple off loading,
imaging, injection of steroid and surgical excision.
PERONEAL / OVERUSE INJURY
The peroneals are the stabilising muscles and tendons located at the outer aspect of
the lower leg. One of these (peroneus brevis) has its tendon enter the foot to the
outer aspect and attach to the base of the 5th metatarsal. The insertion on peroneus brevis is exposed to injury and over use resulting tendonitis, rupture, or subluxation
(displacement) of the tendon.
JONES FRACTURE
This is the name given to the transverse fracture to the base of the 5th metatarsal.
Running sports or sports with aggressive lateral manoeuvres can lead to jones
fractures. They’re also common in athletes taking part in studded field sports the
foot is rapidly forced to an inverted / adducted position.
CUBOID DYSFUNCTION
Cubiod dysfunction can be especially annoying for sufferers and often goes
undiagnosed following a lateral ankle sprain or something as simple as a stumble
from a step for example. Having a displace cuboid bone will affect the overall foot
function and can result in an achy pain to the sole of the foot which in some cases,
radiate through to the top of the foot. It can be relentless for people who have it.
Podiatric foot manipulation techniques can relocate the cuboid bone with affects
often noticeable immediately.
Click Here To Download our MANAGING MIDFOOT CONDITIONS eBOOK
Conditions:
PLANTAR FASCIITIS
Contrary to common understanding, plantar fasciitis is not an inflammatory
condition. It is, rather, a dysfunction of the plantar fascia, micro tearing, or
overloading injury. It is the single most common reason for heel pain in males and
females especially those over the age of 40 who are active. It’s also one of the most
misdiagnosed causes of heel pain. It can be cured but many factors need to be taken
into consideration including body mass, activity, footwear and any underlying
biomechanical causes. Treatment and healing can take a long time.
FIBROMA
The most common cause of lumps to the sole of the foot, fibromas are benign fibrous
lumps which can be annoying at best and painful at worst. They can occur on their
own of be part of a multifocal lesion. Treatment includes simple off loading,
imaging, injection of steroid and surgical excision.
POSTERIOR TIBIAL TENDON DYSFUNCTION
The posterior tibial tendon is important to maintain the foot structure as well as
assist with the explosive muscle power required for jumping, tip toes or just walking
upstairs. Posterior tibial tendon dysfunction (PTTD) is the most common cause of
adult acquired flat foot. The insertion of the tendon to the inside of the arch of the
foot is varied across many boney facets. PTTD can be treated but early intervention
is crucial for optimal outcome. Bracing is sometime required to support the foot and
to allow the PTT to rest and recover. Healing can take several months.
KOHLERS DISEASE
This is a rare condition, seen in children, anytime between 2 and 10 years (typically
3 - 5). Kohlers disease can cause children to limp or avoid using an affected limb.
There is often tenderness or swelling around the navicular bone to the inside of the
arch of the foot. This is often missed because children will adapt readily taking their
body weight on the unaffected limb.
Click Here To Download our MANAGING ARCH PAIN eBOOK
Conditions:
PLANTAR FASCIITIS
Contrary to common understanding, plantar fasciitis is not an inflammatory
condition. It is, rather, a dysfunction of the plantar fascia, micro tearing, or
overloading injury. It is the single most common reason for heel pain in males and
females especially those over the age of 40 who are active. It’s also one of the most
misdiagnosed causes of heel pain. It can be cured but many factors need to be taken
into consideration including body mass, activity, footwear and any underlying
biomechanical causes. Treatment and healing can take a long time.
BAXTERS NERVE ENTRAPMENT
Baxters nerve impingement is often misdiagnosed as plantar fasciitis. Pain caused
by this condition is often described as severe. It can cause problems weight baring,
unlike the pain of plantar fasciitis, which is painful but most people can bear it albeit
uncomfortable. Treatments for baxters nerve entrapment may include orthoses,
manipulation and mobilisation, steroid injection and surgical release if the nerve.
SEVERS DISEASE (CALCANEAL APOPHYSITIS)
Severs disease is a painful inflammation of the heel’s growth plate. It typically
affects children between the ages of 8 to 14 years old because the heel bone is not
fully developed until mid teens. Too much repetitive stress on the growth plate can
result in inflammation can develop. Symptoms include pain in the back or bottom of
the heel, limping, walking on toes, and difficulty running or jumping. Severs disease
is really common in athletic youngsters.
INSERTIONAL ACHILLES TENDINITIS
Achilles Tendonopathy is a common condition where there is pain, swelling,
stiffness, and weakness in your Achilles tendon or at its insertion onto the calcaneum
(heel bone).
Pain can develop gradually especially in the morning upon waking up but is worse
during rest after exercise. The Achilles tendon is important part of your leg which is
found behind and above your heel. It joins the heel bone to your calf muscles. This
helps to bend your foot downwards at the ankle. Overuse of tendons, wearing
inappropriate footwear during exercise, poor flexibility, and increased intensity of
exercise can result to injury in your Achilles tendon. Other causes include arthritis
and long-term use of some antibiotics (e.g. Ciprofloxacin).
RETROCALCENEAL BURSITIS
Retro-calcaneal bursitis (RCB) is a condition characterised by tissue damage and
inflammation of the retro-calcaneal bursa (a small fluid filled sac located at the back
of the heel) causing pain in the heel region. Risk factors include poor foot
biomechanics (particularly flat feet), inappropriate footwear (e.g. excessively tight
fitting shoes), muscle weakness of the calf, quadriceps and gluteals along with
muscle tightness.
HAGLUNDS DEFORMITY
Haglund's deformity is caused by a bony outgrowth (exostosis) from the posterior
calcaneum (heel bone). Its often associated with retro-calcaneal bursitis and
insertional achilles tendinitis. Haglund's deformity typically presents with a
prominent bump on the upper posterior calcaneus. Its causes are not fully
understood. Treatment includes padding and strapping, shoe modification, orthoses
(insoles) rehabilitation and anti-inflammatory medication. In the most severe cases
patients may require surgery.
HEEL SPUR
Heel spurs are often cited as a debilitating cause of heel pain. In fact, heel spurs do
not cause problems for the vast majority of patients who have them. Often they an
incidental finding on foot X-rays. They can be associated with plantar fasciitis but it
is often unclear which condition comes first. By and large having a small bone spur
to the heel is an innocuous condition. Only rarely does a heel spur become large
enough to warrant surgical intervention. For most people off loading through
padding and strapping or orthoses is enough to improve the condition.
OS TRIG SYNDROME
Os trig is the name used to describe the ostrigonum, which is a tiny accessory bone
which can develop behind the talus. Having os trig is thought to be congenital but
often doesn’t become evident until adolescence. Typically suffers describe pain
behind the ankle joint. Overtime the tissues around the os trig can change resulting
in fibrous hypertrophic changes following injury or trauma.
Click Here To Download our MANAGING HEEL PAIN eBOOK
Bottom of the foot (Plantar)
Outside of the foot (Lateral)
Conditions:
Involution
Involution is a condition where the nail has an abnormal increased curvature
causing the nail plate to peak. The curvature can be so excessive in some patient
that the borders of the nail may even appear to curl in on themselves. Some patient
has involution of the nail without any problems at all, while others find it some
painful that nail surgery is sometimes advised.
Ingrown Toenail (Onychocryptosis)
Almost everyone has at least heard of the dreaded ingrown toenail. This painful
condition develops when a spike or a serrated edge of nail has pierced the skin
adjacent to it. This can subsequently become infected and may have
hypergranulation tissue growth if left too long with out treatment. Podiatrists will
endeavour to manage conservatively when possible however, often when we see
them there is not other option except surgery.
Subungal Exostosis
Subungal exostosis occurs when a small outgrowth of bine forms under the nail
plate from the tiny bones within the toe. They can be slow growing to start with but
can lead to daily pain for some sufferers. The cause of subungal exostosis is thought
to be trauma, possibly dropping something on or stubbing the toe. As they grow
they can cause a worrying growth to develop under the nail plate and may produce
exudate.
Thickened Toenails (Onychauxis)
Onychauxis is the name given to the common nail abnormality causing uniform
thickening of the nail plate. Sometime these thick nails can become discoloured
causing some sufferers to become self conscious about their feet. Most of the time its
the big toe nail thats affected but it can occur in any toe. Its important in the elderly
to maintain theses conditions to prevent more serious problems such as subungal
aseptic necrosis developing.
Ram’s Horn Nail (Onychogryphosis)
Onychogryphosis is almost unmistakable because of it obvious resemblance to a
rams horn. These nails are often dark yellow or brown colour. Most of the time its
the big toenail thats affected. It cause is thought to come from the uneven
production of the nail plate cells at the matrix, where the nail is produced. It can be
incredibly uncomfortable and unfortunately is seen most often in the elderly or in
cases of neglect.
Corn Under The Nail (Subungal Heloma)
A subungal heloma is just like any other hard corn but unfortunately its located
under the nail plate. Hard cords are caused by prolonged pressure and the result is
the skins reaction to that enduring force causing keratin to be produced quickly, in
order to protect, however, more often that not if becomes incredibly painful for the
sufferer. In order to remove the corn the nail will need to be cut back to allow access
for the podiatrist. If the pressure which caused the corn remains the suffer can
expect it to return. That's why addressing any footwear issues is critical for a long
term, satisfactory outcome.
Paronychia
This is the name given to the inflammation and/or infection of the tissue
surrounding the nail plate. Although paronychia may not sound too serious they can
result in tracking bacterial infection so should never be ignored. Patients often
require antibiotic treatment, draining and dressings of the infected site.
Fungal Nail Infections (Onychomychosis and Tinea Unguium)
Fungal nails account for one of the most common conditions we see relating to the
nail. Sufferers from fungal nail infection can become very self conscious about their
feet. The human nail plate provides a very stable environment for the fungus to
grow. Infected nails may become thick, brittle, powdery or yellow brown
appearance.
Having associated skin infections is thought to contribute to the development of
fungal nail infections which is is why its important when treating fungal nail problems that the treatment of the skin is part of the process.
Treatment of fungal skin and nail infections can take a frustratingly long time to
resolve. Working closely with your podiatrist will provide the best outcomes. Be
prepared for regular check ins with your podiatrist for frequent nail debulking and/
or treatment application.
Click Here To Download our MANAGING NAIL CONDITIONS eBOOK
Conditions:
Hammer toe
Hammertoe is the term used to describe a deformity of one or more of the lesser toes
where one or both joints of the toes caused by an imbalance in the muscle control to
the toes. For some people this deformity can result in abnormal pressure from
footwear which can result in callus, corns and other painful skin changes.
Click Here To Download our MANAGING DIGITAL CONDITIONS eBOOK
Conditions:
Hallux valgus
Otherwise known as a 'bunion', hallux valgus causes an inward deformity of the big to resulting in a subluxation of the joint causing arthritic pain and friction from footwear.
Hallux limitus/rigidus
Hallux limitus/rigidus is loss of full motion in the joint of the big toe caused by biomechanical dysfunction that can also lead to arthritic changes in the joint.
Turf toe
Turf toe is caused by trauma where the big toe hits the ground during sport causing the joint to compress. It can cause long term joint damage if not managed correctly.
Inter-metatarsal Bursitis
Bursae are fluid filled structures which surround our joints, tendons, ligaments and
within various layers / structures within our bodies. Bursae are essential to reduce
friction, and help structures to glide easily, providing protection for the anatomy.
The inter-metatarsal bursae are located on the bottom of the foot near the base of
the toes. They can become inflamed when the forces acting on the are excessive
caused by loss of fatty protection, walking barefoot, or excessive loading through
over training of wearing the wrong shoe.
Capsulitis
Our joints are lined with protective covering Inflammation of the tissues that line the
joints, often under the ball of the foot. It causes redness, swelling, warmth, and pain
on weight bearing or with joint motion. Sometimes if they are inflamed weight
bearing can be painful, and you may have redness, heat and/or swelling.
Plantar Plate Tear / Rupture
Plantar plate injuries have become better understood recently owing to the
improvements in medial imaging. The plate is a thick ligament under the ball of the
foot which extends to the first joints of the toes. It protects toe joints from pressure
and injury and prevents excessive dorsiflexion. When the plantar plate is injured,
you may feel anything form moderate to severe symptoms. You might even notice
that one or more of your toes has ‘Popped” up or become splayed. Sufferers often
describe a feeling of walking on a stone in plantar plate injury.
Stress / March Fracture
Stress Fractures are quite a common cause of foot pin, especially in runners or
athletes who have increased their training loads or regimes causing repeated
trauma to a small area of bone. Calcium and vitamin D deficiency is linked with
stress fracture along with osteoporosis.
Freibergs Disease
Freibergs disease is not common but its something to be aware of, particularly in
adolescents who are still growing. Its causes by necrosis ( death ) of the bone of the
metatarsal head ( osteonecrosis). It’s also sometimes called Freiberg’s infarction.
Nerve Entrapment / Neuroma
Neuromas can occur anywhere. In the forefoot they’re most commonly encountered
between the lesser metatarsals, typically 3rd and 4th. They’re caused by an
inflammation and thickening of the perineurial sheath which covers the nerve. When
the become bigger (space occupying) they can become very sore. Neuromas are
relatively common. They can be aggravated by tight fitting shoes and can cause
pain which radiates up or around the foot. Typically the pain doesn’t make much
sense for the sufferer and they often find it hard to describe.
Click Here To Download our MANAGING FOREFOOT CONDITIONS eBOOK
Conditions:
LISFRANCS INJURY
The Lisfranc joint is the area of articulation between the mid foot and forefoot: Its
made up of the five tarsometatarsal joints in all. Foot fractures and traumatic
ligament injuries can result in deformity, instability, pain and degenerative disease
of the Lisfranc joint. Injuries to the Lisfranc ligament complex have been associated
with high-energy trauma (eg, motor vehicle collisions), they can also result from
low-energy trauma, including leisure activities or athletic activity.You may notice a
defined area of bruising to the sole of the foot. This is often a sign of Lisfrancs injury.
MID FOOT ARTHRITIS
The foot anatomy is complex. The foot itself has 26 bones on average with a
multitude of small articular surfaces among its 33 joints. Many of these joints are
small but the forces we place through them are huge. Over the course of our normal
daily activities, these joints can change, become damaged and dysfunctional. This is
the arthritic process and the small joints in the feet are particularly vulnerable,
causing achy stiffness or pain during or after exercise.
PLANTAR FIBROMA
The most common cause of lumps to the sole of the foot, fibromas are benign fibrous
lumps which can be annoying at best and painful at worst. They can occur on their
own of be part of a multifocal lesion. Treatment includes simple off loading,
imaging, injection of steroid and surgical excision.
PERONEAL / OVERUSE INJURY
The peroneals are the stabilising muscles and tendons located at the outer aspect of
the lower leg. One of these (peroneus brevis) has its tendon enter the foot to the
outer aspect and attach to the base of the 5th metatarsal. The insertion on peroneus brevis is exposed to injury and over use resulting tendonitis, rupture, or subluxation
(displacement) of the tendon.
JONES FRACTURE
This is the name given to the transverse fracture to the base of the 5th metatarsal.
Running sports or sports with aggressive lateral manoeuvres can lead to jones
fractures. They’re also common in athletes taking part in studded field sports the
foot is rapidly forced to an inverted / adducted position.
CUBOID DYSFUNCTION
Cubiod dysfunction can be especially annoying for sufferers and often goes
undiagnosed following a lateral ankle sprain or something as simple as a stumble
from a step for example. Having a displace cuboid bone will affect the overall foot
function and can result in an achy pain to the sole of the foot which in some cases,
radiate through to the top of the foot. It can be relentless for people who have it.
Podiatric foot manipulation techniques can relocate the cuboid bone with affects
often noticeable immediately.
Click Here To Download our MANAGING MIDFOOT CONDITIONS eBOOK
Conditions:
PLANTAR FASCIITIS
Contrary to common understanding, plantar fasciitis is not an inflammatory
condition. It is, rather, a dysfunction of the plantar fascia, micro tearing, or
overloading injury. It is the single most common reason for heel pain in males and
females especially those over the age of 40 who are active. It’s also one of the most
misdiagnosed causes of heel pain. It can be cured but many factors need to be taken
into consideration including body mass, activity, footwear and any underlying
biomechanical causes. Treatment and healing can take a long time.
BAXTERS NERVE ENTRAPMENT
Baxters nerve impingement is often misdiagnosed as plantar fasciitis. Pain caused
by this condition is often described as severe. It can cause problems weight baring,
unlike the pain of plantar fasciitis, which is painful but most people can bear it albeit
uncomfortable. Treatments for baxters nerve entrapment may include orthoses,
manipulation and mobilisation, steroid injection and surgical release if the nerve.
SEVERS DISEASE (CALCANEAL APOPHYSITIS)
Severs disease is a painful inflammation of the heel’s growth plate. It typically
affects children between the ages of 8 to 14 years old because the heel bone is not
fully developed until mid teens. Too much repetitive stress on the growth plate can
result in inflammation can develop. Symptoms include pain in the back or bottom of
the heel, limping, walking on toes, and difficulty running or jumping. Severs disease
is really common in athletic youngsters.
INSERTIONAL ACHILLES TENDINITIS
Achilles Tendonopathy is a common condition where there is pain, swelling,
stiffness, and weakness in your Achilles tendon or at its insertion onto the calcaneum
(heel bone).
Pain can develop gradually especially in the morning upon waking up but is worse
during rest after exercise. The Achilles tendon is important part of your leg which is
found behind and above your heel. It joins the heel bone to your calf muscles. This
helps to bend your foot downwards at the ankle. Overuse of tendons, wearing
inappropriate footwear during exercise, poor flexibility, and increased intensity of
exercise can result to injury in your Achilles tendon. Other causes include arthritis
and long-term use of some antibiotics (e.g. Ciprofloxacin).
RETROCALCENEAL BURSITIS
Retro-calcaneal bursitis (RCB) is a condition characterised by tissue damage and
inflammation of the retro-calcaneal bursa (a small fluid filled sac located at the back
of the heel) causing pain in the heel region. Risk factors include poor foot
biomechanics (particularly flat feet), inappropriate footwear (e.g. excessively tight
fitting shoes), muscle weakness of the calf, quadriceps and gluteals along with
muscle tightness.
HAGLUNDS DEFORMITY
Haglund's deformity is caused by a bony outgrowth (exostosis) from the posterior
calcaneum (heel bone). Its often associated with retro-calcaneal bursitis and
insertional achilles tendinitis. Haglund's deformity typically presents with a
prominent bump on the upper posterior calcaneus. Its causes are not fully
understood. Treatment includes padding and strapping, shoe modification, orthoses
(insoles) rehabilitation and anti-inflammatory medication. In the most severe cases
patients may require surgery.
HEEL SPUR
Heel spurs are often cited as a debilitating cause of heel pain. In fact, heel spurs do
not cause problems for the vast majority of patients who have them. Often they an
incidental finding on foot X-rays. They can be associated with plantar fasciitis but it
is often unclear which condition comes first. By and large having a small bone spur
to the heel is an innocuous condition. Only rarely does a heel spur become large
enough to warrant surgical intervention. For most people off loading through
padding and strapping or orthoses is enough to improve the condition.
OS TRIG SYNDROME
Os trig is the name used to describe the ostrigonum, which is a tiny accessory bone
which can develop behind the talus. Having os trig is thought to be congenital but
often doesn’t become evident until adolescence. Typically suffers describe pain
behind the ankle joint. Overtime the tissues around the os trig can change resulting
in fibrous hypertrophic changes following injury or trauma.
Click Here To Download our MANAGING HEEL PAIN eBOOK
Conditions:
Involution
Involution is a condition where the nail has an abnormal increased curvature
causing the nail plate to peak. The curvature can be so excessive in some patient
that the borders of the nail may even appear to curl in on themselves. Some patient
has involution of the nail without any problems at all, while others find it some
painful that nail surgery is sometimes advised.
Ingrown Toenail (Onychocryptosis)
Almost everyone has at least heard of the dreaded ingrown toenail. This painful
condition develops when a spike or a serrated edge of nail has pierced the skin
adjacent to it. This can subsequently become infected and may have
hypergranulation tissue growth if left too long with out treatment. Podiatrists will
endeavour to manage conservatively when possible however, often when we see
them there is not other option except surgery.
Subungal Exostosis
Subungal exostosis occurs when a small outgrowth of bine forms under the nail
plate from the tiny bones within the toe. They can be slow growing to start with but
can lead to daily pain for some sufferers. The cause of subungal exostosis is thought
to be trauma, possibly dropping something on or stubbing the toe. As they grow
they can cause a worrying growth to develop under the nail plate and may produce
exudate.
Thickened Toenails (Onychauxis)
Onychauxis is the name given to the common nail abnormality causing uniform
thickening of the nail plate. Sometime these thick nails can become discoloured
causing some sufferers to become self conscious about their feet. Most of the time its
the big toe nail thats affected but it can occur in any toe. Its important in the elderly
to maintain theses conditions to prevent more serious problems such as subungal
aseptic necrosis developing.
Ram’s Horn Nail (Onychogryphosis)
Onychogryphosis is almost unmistakable because of it obvious resemblance to a
rams horn. These nails are often dark yellow or brown colour. Most of the time its
the big toenail thats affected. It cause is thought to come from the uneven
production of the nail plate cells at the matrix, where the nail is produced. It can be
incredibly uncomfortable and unfortunately is seen most often in the elderly or in
cases of neglect.
Corn Under The Nail (Subungal Heloma)
A subungal heloma is just like any other hard corn but unfortunately its located
under the nail plate. Hard cords are caused by prolonged pressure and the result is
the skins reaction to that enduring force causing keratin to be produced quickly, in
order to protect, however, more often that not if becomes incredibly painful for the
sufferer. In order to remove the corn the nail will need to be cut back to allow access
for the podiatrist. If the pressure which caused the corn remains the suffer can
expect it to return. That's why addressing any footwear issues is critical for a long
term, satisfactory outcome.
Paronychia
This is the name given to the inflammation and/or infection of the tissue
surrounding the nail plate. Although paronychia may not sound too serious they can
result in tracking bacterial infection so should never be ignored. Patients often
require antibiotic treatment, draining and dressings of the infected site.
Fungal Nail Infections (Onychomychosis and Tinea Unguium)
Fungal nails account for one of the most common conditions we see relating to the
nail. Sufferers from fungal nail infection can become very self conscious about their
feet. The human nail plate provides a very stable environment for the fungus to
grow. Infected nails may become thick, brittle, powdery or yellow brown
appearance.
Having associated skin infections is thought to contribute to the development of
fungal nail infections which is is why its important when treating fungal nail problems that the treatment of the skin is part of the process.
Treatment of fungal skin and nail infections can take a frustratingly long time to
resolve. Working closely with your podiatrist will provide the best outcomes. Be
prepared for regular check ins with your podiatrist for frequent nail debulking and/
or treatment application.
Click Here To Download our MANAGING NAIL CONDITIONS eBOOK
Conditions:
Hammer toe
Hammertoe is the term used to describe a deformity of one or more of the lesser toes
where one or both joints of the toes caused by an imbalance in the muscle control to
the toes. For some people this deformity can result in abnormal pressure from
footwear which can result in callus, corns and other painful skin changes.
Click Here To Download our MANAGING DIGITAL CONDITIONS eBOOK
Conditions:
Hallux valgus
Otherwise known as a 'bunion', hallux valgus causes an inward deformity of the big to resulting in a subluxation of the joint causing arthritic pain and friction from footwear.
Hallux limitus/rigidus
Hallux limitus/rigidus is loss of full motion in the joint of the big toe caused by biomechanical dysfunction that can also lead to arthritic changes in the joint.
Turf toe
Turf toe is caused by trauma where the big toe hits the ground during sport causing the joint to compress. It can cause long term joint damage if not managed correctly.
Inter-metatarsal Bursitis
Bursae are fluid filled structures which surround our joints, tendons, ligaments and
within various layers / structures within our bodies. Bursae are essential to reduce
friction, and help structures to glide easily, providing protection for the anatomy.
The inter-metatarsal bursae are located on the bottom of the foot near the base of
the toes. They can become inflamed when the forces acting on the are excessive
caused by loss of fatty protection, walking barefoot, or excessive loading through
over training of wearing the wrong shoe.
Capsulitis
Our joints are lined with protective covering Inflammation of the tissues that line the
joints, often under the ball of the foot. It causes redness, swelling, warmth, and pain
on weight bearing or with joint motion. Sometimes if they are inflamed weight
bearing can be painful, and you may have redness, heat and/or swelling.
Plantar Plate Tear / Rupture
Plantar plate injuries have become better understood recently owing to the
improvements in medial imaging. The plate is a thick ligament under the ball of the
foot which extends to the first joints of the toes. It protects toe joints from pressure
and injury and prevents excessive dorsiflexion. When the plantar plate is injured,
you may feel anything form moderate to severe symptoms. You might even notice
that one or more of your toes has ‘Popped” up or become splayed. Sufferers often
describe a feeling of walking on a stone in plantar plate injury.
Stress / March Fracture
Stress Fractures are quite a common cause of foot pin, especially in runners or
athletes who have increased their training loads or regimes causing repeated
trauma to a small area of bone. Calcium and vitamin D deficiency is linked with
stress fracture along with osteoporosis.
Freibergs Disease
Freibergs disease is not common but its something to be aware of, particularly in
adolescents who are still growing. Its causes by necrosis ( death ) of the bone of the
metatarsal head ( osteonecrosis). It’s also sometimes called Freiberg’s infarction.
Nerve Entrapment / Neuroma
Neuromas can occur anywhere. In the forefoot they’re most commonly encountered
between the lesser metatarsals, typically 3rd and 4th. They’re caused by an
inflammation and thickening of the perineurial sheath which covers the nerve. When
the become bigger (space occupying) they can become very sore. Neuromas are
relatively common. They can be aggravated by tight fitting shoes and can cause
pain which radiates up or around the foot. Typically the pain doesn’t make much
sense for the sufferer and they often find it hard to describe.
Click Here To Download our MANAGING FOREFOOT CONDITIONS eBOOK
Conditions:
LISFRANCS INJURY
The Lisfranc joint is the area of articulation between the mid foot and forefoot: Its
made up of the five tarsometatarsal joints in all. Foot fractures and traumatic
ligament injuries can result in deformity, instability, pain and degenerative disease
of the Lisfranc joint. Injuries to the Lisfranc ligament complex have been associated
with high-energy trauma (eg, motor vehicle collisions), they can also result from
low-energy trauma, including leisure activities or athletic activity.You may notice a
defined area of bruising to the sole of the foot. This is often a sign of Lisfrancs injury.
MID FOOT ARTHRITIS
The foot anatomy is complex. The foot itself has 26 bones on average with a
multitude of small articular surfaces among its 33 joints. Many of these joints are
small but the forces we place through them are huge. Over the course of our normal
daily activities, these joints can change, become damaged and dysfunctional. This is
the arthritic process and the small joints in the feet are particularly vulnerable,
causing achy stiffness or pain during or after exercise.
PLANTAR FIBROMA
The most common cause of lumps to the sole of the foot, fibromas are benign fibrous
lumps which can be annoying at best and painful at worst. They can occur on their
own of be part of a multifocal lesion. Treatment includes simple off loading,
imaging, injection of steroid and surgical excision.
PERONEAL / OVERUSE INJURY
The peroneals are the stabilising muscles and tendons located at the outer aspect of
the lower leg. One of these (peroneus brevis) has its tendon enter the foot to the
outer aspect and attach to the base of the 5th metatarsal. The insertion on peroneus brevis is exposed to injury and over use resulting tendonitis, rupture, or subluxation
(displacement) of the tendon.
JONES FRACTURE
This is the name given to the transverse fracture to the base of the 5th metatarsal.
Running sports or sports with aggressive lateral manoeuvres can lead to jones
fractures. They’re also common in athletes taking part in studded field sports the
foot is rapidly forced to an inverted / adducted position.
CUBOID DYSFUNCTION
Cubiod dysfunction can be especially annoying for sufferers and often goes
undiagnosed following a lateral ankle sprain or something as simple as a stumble
from a step for example. Having a displace cuboid bone will affect the overall foot
function and can result in an achy pain to the sole of the foot which in some cases,
radiate through to the top of the foot. It can be relentless for people who have it.
Podiatric foot manipulation techniques can relocate the cuboid bone with affects
often noticeable immediately.
Click Here To Download our MANAGING MIDFOOT CONDITIONS eBOOK
Conditions:
PLANTAR FASCIITIS
Contrary to common understanding, plantar fasciitis is not an inflammatory
condition. It is, rather, a dysfunction of the plantar fascia, micro tearing, or
overloading injury. It is the single most common reason for heel pain in males and
females especially those over the age of 40 who are active. It’s also one of the most
misdiagnosed causes of heel pain. It can be cured but many factors need to be taken
into consideration including body mass, activity, footwear and any underlying
biomechanical causes. Treatment and healing can take a long time.
BAXTERS NERVE ENTRAPMENT
Baxters nerve impingement is often misdiagnosed as plantar fasciitis. Pain caused
by this condition is often described as severe. It can cause problems weight baring,
unlike the pain of plantar fasciitis, which is painful but most people can bear it albeit
uncomfortable. Treatments for baxters nerve entrapment may include orthoses,
manipulation and mobilisation, steroid injection and surgical release if the nerve.
SEVERS DISEASE (CALCANEAL APOPHYSITIS)
Severs disease is a painful inflammation of the heel’s growth plate. It typically
affects children between the ages of 8 to 14 years old because the heel bone is not
fully developed until mid teens. Too much repetitive stress on the growth plate can
result in inflammation can develop. Symptoms include pain in the back or bottom of
the heel, limping, walking on toes, and difficulty running or jumping. Severs disease
is really common in athletic youngsters.
INSERTIONAL ACHILLES TENDINITIS
Achilles Tendonopathy is a common condition where there is pain, swelling,
stiffness, and weakness in your Achilles tendon or at its insertion onto the calcaneum
(heel bone).
Pain can develop gradually especially in the morning upon waking up but is worse
during rest after exercise. The Achilles tendon is important part of your leg which is
found behind and above your heel. It joins the heel bone to your calf muscles. This
helps to bend your foot downwards at the ankle. Overuse of tendons, wearing
inappropriate footwear during exercise, poor flexibility, and increased intensity of
exercise can result to injury in your Achilles tendon. Other causes include arthritis
and long-term use of some antibiotics (e.g. Ciprofloxacin).
RETROCALCENEAL BURSITIS
Retro-calcaneal bursitis (RCB) is a condition characterised by tissue damage and
inflammation of the retro-calcaneal bursa (a small fluid filled sac located at the back
of the heel) causing pain in the heel region. Risk factors include poor foot
biomechanics (particularly flat feet), inappropriate footwear (e.g. excessively tight
fitting shoes), muscle weakness of the calf, quadriceps and gluteals along with
muscle tightness.
HAGLUNDS DEFORMITY
Haglund's deformity is caused by a bony outgrowth (exostosis) from the posterior
calcaneum (heel bone). Its often associated with retro-calcaneal bursitis and
insertional achilles tendinitis. Haglund's deformity typically presents with a
prominent bump on the upper posterior calcaneus. Its causes are not fully
understood. Treatment includes padding and strapping, shoe modification, orthoses
(insoles) rehabilitation and anti-inflammatory medication. In the most severe cases
patients may require surgery.
HEEL SPUR
Heel spurs are often cited as a debilitating cause of heel pain. In fact, heel spurs do
not cause problems for the vast majority of patients who have them. Often they an
incidental finding on foot X-rays. They can be associated with plantar fasciitis but it
is often unclear which condition comes first. By and large having a small bone spur
to the heel is an innocuous condition. Only rarely does a heel spur become large
enough to warrant surgical intervention. For most people off loading through
padding and strapping or orthoses is enough to improve the condition.
OS TRIG SYNDROME
Os trig is the name used to describe the ostrigonum, which is a tiny accessory bone
which can develop behind the talus. Having os trig is thought to be congenital but
often doesn’t become evident until adolescence. Typically suffers describe pain
behind the ankle joint. Overtime the tissues around the os trig can change resulting
in fibrous hypertrophic changes following injury or trauma.
Click Here To Download our MANAGING HEEL PAIN eBOOK
Inside of the foot (Medial)
